HyRISE: Resistance Interpretation & Scoring Engine
HIV Drug Resistance Sequencing Analysis Report
Interpretation of HIV drug resistance mutations derived from sequencing data. This report combines Sierra-Local outputs with HyRISE visualizations to summarize resistance patterns, mutation profiles, and potential treatment impact.
- Sample Name
- DEMO_COMBO_NGS
- Analysis Date
- 2026-02-19 10:29:41
- Genes Analyzed
- IN, PR, RT
- Stanford DB Version
- 10.1
- Stanford DB Date
- 2026-01-18
- IN Mut / SDRM
- 9 / 1
- PR Mut / SDRM
- 27 / 4
- RT Mut / SDRM
- 32 / 8
- HyRISE Version
- 0.2.2
Report
generated on 2026-02-19, 10:29 CST
IN Mutation Position Map
Interactive visualization of mutations along the IN gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.
Interactive map of integrase mutation positions with functional-domain context and position-level details.
IN Mutation Position Map
This visualization shows 9 mutations detected in the IN gene (positions 1-289), including 1 major resistance mutations and 1 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.
1-100
10Position 10
- E10D - OtherChanged from E to D
20
30
40
50
60
70
72Position 72
- I72V - OtherChanged from I to V
74Position 74
- L74M - AccessoryChanged from L to M
80
90
100
101-200
110
120
121Position 121
- F121Y - Major (SDRM)Changed from F to Y
124Position 124
- T124A - OtherChanged from T to A
130
140
150
151Position 151
- V151I - OtherChanged from V to I
160
163Position 163
- G163R - AccessoryChanged from G to R
170
180
190
200
201-289
210
220
230
232Position 232
- D232N - AccessoryChanged from D to N
240
250
256Position 256
- D256ND - Other (APOBEC)Changed from D to DN
260
270
280
Major Mutation (Directly confers resistance)
Accessory Mutation (Enhances resistance)
Other Mutation (Polymorphism or unknown effect)
Surveillance Drug Resistance Mutation (SDRM)
APOBEC-mediated mutation
Mutation Distribution Summary
| Mutation Type | Count | Percentage |
|---|---|---|
| Major Mutations | 1 | 11.1% |
| Accessory Mutations | 3 | 33.3% |
| Other Mutations | 5 | 55.6% |
| SDRM Mutations | 1 | 11.1% |
| APOBEC-Mediated Mutations | 1 | 11.1% |
| Total Mutations | 9 | 100.0% |
IN Mutation-Specific Resistance Contribution
Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in IN, highlighting the relative impact of specific mutations on drug efficacy.
Per-mutation contribution of integrase variants to INSTI resistance scores, including primary and accessory pathways.
| Drug | Drug | Class | Drug Priority | Mutations | Type | SDRM | Contribution | Weighted | Total Score | % of Total | Impact Category | Clinical Comment |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BIC_F121Y | BIC | INSTI | 5 | F121Y | Major | No | 10 | 16.7 | 15 | 66.7% | Major | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| BIC_L74M | BIC | INSTI | 5 | L74M | Other | No | 5 | 8.3 | 15 | 33.3% | Significant (High-Priority Drug) | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| CAB_F121Y | CAB | INSTI | 3 | F121Y | Major | No | 15 | 15.0 | 20 | 75.0% | Dominant | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| CAB_L74M | CAB | INSTI | 3 | L74M | Other | No | 5 | 5.0 | 20 | 25.0% | Significant | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| DTG_F121Y | DTG | INSTI | 5 | F121Y | Major | No | 10 | 16.7 | 15 | 66.7% | Major | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| DTG_L74M | DTG | INSTI | 5 | L74M | Other | No | 5 | 8.3 | 15 | 33.3% | Significant (High-Priority Drug) | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| EVG_D232N | EVG | INSTI | 3 | D232N | Other | No | 10 | 10.0 | 95 | 10.5% | Minor | D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility. |
| EVG_F121Y | EVG | INSTI | 3 | F121Y | Major | No | 60 | 60.0 | 95 | 63.2% | Major | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| EVG_G163R | EVG | INSTI | 3 | G163R | Accessory | No | 15 | 15.0 | 95 | 15.8% | Minor | G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized. |
| EVG_L74M | EVG | INSTI | 3 | L74M | Other | No | 5 | 5.0 | 95 | 5.3% | Minor | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| EVG_V151I | EVG | INSTI | 3 | V151I | Other | No | 5 | 5.0 | 95 | 5.3% | Minor | V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs. |
| RAL_D232N | RAL | INSTI | 3 | D232N | Other | No | 10 | 10.0 | 95 | 10.5% | Minor | D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility. |
| RAL_F121Y | RAL | INSTI | 3 | F121Y | Major | No | 60 | 60.0 | 95 | 63.2% | Major | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| RAL_G163R | RAL | INSTI | 3 | G163R | Accessory | No | 15 | 15.0 | 95 | 15.8% | Minor | G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized. |
| RAL_L74M | RAL | INSTI | 3 | L74M | Other | No | 5 | 5.0 | 95 | 5.3% | Minor | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| RAL_V151I | RAL | INSTI | 3 | V151I | Other | No | 5 | 5.0 | 95 | 5.3% | Minor | V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs. |
IN Mutations
Comprehensive listing of all mutations detected in the IN gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.
Filterable catalog of integrase mutations with positions, resistance attributes, and special labels.
| Mutation | Mutation | Position | Type | SDRM | APOBEC | Unusual | Structure |
|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_D232N | D232N | 232 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_D256ND | D256ND | 256 | Other | No | Yes | No | Substitution |
| DEMO_COMBO_NGS_E10D | E10D | 10 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_F121Y | F121Y | 121 | Major | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_G163R | G163R | 163 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_I72V | I72V | 72 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L74M | L74M | 74 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_T124A | T124A | 124 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V151I | V151I | 151 | Other | No | No | No | Substitution |
IN Mutation Summary
Summary of mutation types detected in the IN gene, including counts, percentages, and complete lists of mutations by type.
Distribution of integrase mutation types by clinical relevance, including major pathway and accessory mutations.
| Mutation Type | Count | Percentage | Mutations | Clinical Implication |
|---|---|---|---|---|
| Major | 1 | 11.1% | F121Y | Direct resistance to one or more drugs |
| Accessory | 3 | 33.3% | D232N, G163R, L74M | Enhance resistance when present with major mutations |
| SDRM | 1 | 11.1% | F121Y | Used for surveillance of transmitted resistance |
| APOBEC | 1 | 11.1% | D256ND | Artifacts of APOBEC-mediated hypermutation |
| Other | 5 | 55.6% | D256ND, E10D, I72V, T124A, V151I | Polymorphisms or mutations with minimal impact on drug resistance |
IN Mutation Clinical Significance
Consolidated analysis of IN mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.
Clinical interpretation of integrase mutations, covering effects on target binding, enzyme function, and resistance pathways.
| Mutation Type | Type | Mutation | SDRM | APOBEC | Affected Drugs | Max Impact | Clinical Implication |
|---|---|---|---|---|---|---|---|
| Accessory_G163R | Accessory | G163R | No | No | EVG (INSTI) (15.0), RAL (INSTI) (15.0) | 15 | G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized. |
| INSTI_D232N | INSTI | D232N | No | No | EVG (INSTI) (10.0), RAL (INSTI) (10.0) | 10 | D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility. |
| Major_F121Y | Major | F121Y | Yes | No | EVG (INSTI) (60.0), RAL (INSTI) (60.0), CAB (INSTI) (15.0), BIC (INSTI) (10.0), DTG (INSTI) (10.0) | 60 | F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC. |
| Other_L74M | Other | L74M | No | No | BIC (INSTI) (5.0), CAB (INSTI) (5.0), DTG (INSTI) (5.0), EVG (INSTI) (5.0), RAL (INSTI) (5.0) | 5 | L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs. |
| Other_V151I | Other | V151I | No | No | EVG (INSTI) (5.0), RAL (INSTI) (5.0) | 5 | V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs. |
IN Drug Resistance Profile
Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for IN gene.
Drug-level INSTI resistance profile with quantitative scoring, interpretation, and clinically weighted comparison.
| Drug | Drug | Class | Score | Weighted Score | Priority | SIR | Level | Interpretation |
|---|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_BIC | BIC | INSTI | 15 | 25.0 | 5 | I | 3 | Low-Level Resistance |
| DEMO_COMBO_NGS_CAB | CAB | INSTI | 20 | 20.0 | 3 | I | 3 | Low-Level Resistance |
| DEMO_COMBO_NGS_DTG | DTG | INSTI | 15 | 25.0 | 5 | I | 3 | Low-Level Resistance |
| DEMO_COMBO_NGS_EVG | EVG | INSTI | 95 | 95.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_RAL | RAL | INSTI | 95 | 95.0 | 3 | R | 5 | High-Level Resistance |
IN Drug Class Overview
Summary of drug resistance patterns by drug class for IN. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 2 high-priority drugs affected.
Summary of integrase inhibitor resistance across first-generation (RAL, EVG) and second-generation (DTG, BIC, CAB) INSTIs.
| Drug Class | Drug Class | Total Drugs | Resistant | % Resistant | Weighted Score | High-Priority | Max Score | Status | High | Int | Low | Pot | Sus |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IN_INSTI | INSTI | 5 | 5 | 100.0% | 52.0 | 2 | 95 | High-level resistance | 2 | 0 | 3 | 0 | 0 |
PR Mutation Position Map
Interactive visualization of mutations along the PR gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.
Interactive map of protease mutation positions across the gene, with type-based coloring, SDRM highlighting, and per-position tooltips.
PR Mutation Position Map
This visualization shows 27 mutations detected in the PR gene (positions 1-99), including 3 major resistance mutations and 4 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.
1-99
10Position 10
- L10R - OtherChanged from L to R
11Position 11
- V11L - OtherChanged from V to L
13Position 13
- I13V - OtherChanged from I to V
15Position 15
- I15V - OtherChanged from I to V
19Position 19
- L19I - OtherChanged from L to I
20Position 20
- K20T - AccessoryChanged from K to T
30
32Position 32
- V32I - Major (SDRM)Changed from V to I
33Position 33
- L33F - AccessoryChanged from L to F
35Position 35
- E35G - OtherChanged from E to G
36Position 36
- M36I - OtherChanged from M to I
37Position 37
- N37T - OtherChanged from N to T
39Position 39
- P39PS - OtherChanged from P to PS
40
41Position 41
- R41K - OtherChanged from R to K
47Position 47
- I47V - Major (SDRM)Changed from I to V
50
58Position 58
- Q58E - AccessoryChanged from Q to E
60Position 60
- D60E - OtherChanged from D to E
62Position 62
- I62V - OtherChanged from I to V
63Position 63
- L63P - OtherChanged from L to P
70Position 70
- K70E - OtherChanged from K to E
71Position 71
- A71V - OtherChanged from A to V
73Position 73
- G73S - Accessory (SDRM)Changed from G to S
77Position 77
- V77I - OtherChanged from V to I
80
82Position 82
- V82I - OtherChanged from V to I
89Position 89
- L89V - AccessoryChanged from L to V
90Position 90
- L90M - Major (SDRM)Changed from L to M
93Position 93
- I93L - OtherChanged from I to L
95Position 95
- C95V - OtherChanged from C to V
Major Mutation (Directly confers resistance)
Accessory Mutation (Enhances resistance)
Other Mutation (Polymorphism or unknown effect)
Surveillance Drug Resistance Mutation (SDRM)
APOBEC-mediated mutation
Mutation Distribution Summary
| Mutation Type | Count | Percentage |
|---|---|---|
| Major Mutations | 3 | 11.1% |
| Accessory Mutations | 5 | 18.5% |
| Other Mutations | 19 | 70.4% |
| SDRM Mutations | 4 | 14.8% |
| Total Mutations | 27 | 100.0% |
PR Mutation-Specific Resistance Contribution
Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in PR, highlighting the relative impact of specific mutations on drug efficacy.
Per-mutation contribution of protease variants to resistance scores for each PI, highlighting dominant resistance drivers.
| Drug | Drug | Class | Drug Priority | Mutations | Type | SDRM | Contribution | Weighted | Total Score | % of Total | Impact Category | Clinical Comment |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ATV_r_G73S | ATV/r | PI | 3 | G73S | Accessory | No | 10 | 10.0 | 80 | 12.5% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| ATV_r_G73S_+_L90M | ATV/r | PI | 3 | G73S + L90M | Major | No | 10 | 10.0 | 80 | 12.5% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| ATV_r_I47V | ATV/r | PI | 3 | I47V | Major | No | 10 | 10.0 | 80 | 12.5% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| ATV_r_K20T | ATV/r | PI | 3 | K20T | Accessory | No | 5 | 5.0 | 80 | 6.2% | Minor | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| ATV_r_L33F | ATV/r | PI | 3 | L33F | Accessory | No | 5 | 5.0 | 80 | 6.2% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| ATV_r_L90M | ATV/r | PI | 3 | L90M | Major | No | 20 | 20.0 | 80 | 25.0% | Significant | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| ATV_r_V32I | ATV/r | PI | 3 | V32I | Major | No | 15 | 15.0 | 80 | 18.8% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| ATV_r_V32I_+_I47V | ATV/r | PI | 3 | V32I + I47V | Major | No | 5 | 5.0 | 80 | 6.2% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| DRV_r_I47V | DRV/r | PI | 5 | I47V | Major | No | 10 | 16.7 | 50 | 20.0% | Minor (High-Priority Drug) | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| DRV_r_L33F | DRV/r | PI | 5 | L33F | Accessory | No | 5 | 8.3 | 50 | 10.0% | Minor (High-Priority Drug) | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| DRV_r_L89V | DRV/r | PI | 5 | L89V | Accessory | No | 5 | 8.3 | 50 | 10.0% | Minor (High-Priority Drug) | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| DRV_r_V11L_+_V32I | DRV/r | PI | 5 | V11L + V32I | Major | No | 5 | 8.3 | 50 | 10.0% | Minor (High-Priority Drug) | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| DRV_r_V32I | DRV/r | PI | 5 | V32I | Major | No | 15 | 25.0 | 50 | 30.0% | Significant (High-Priority Drug) | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| DRV_r_V32I_+_I47V | DRV/r | PI | 5 | V32I + I47V | Major | No | 5 | 8.3 | 50 | 10.0% | Minor (High-Priority Drug) | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| DRV_r_V32I_+_L89V | DRV/r | PI | 5 | V32I + L89V | Major | No | 5 | 8.3 | 50 | 10.0% | Minor (High-Priority Drug) | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| FPV_r_G73S | FPV/r | PI | 3 | G73S | Accessory | No | 10 | 10.0 | 145 | 6.9% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| FPV_r_G73S_+_L90M | FPV/r | PI | 3 | G73S + L90M | Major | No | 10 | 10.0 | 145 | 6.9% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| FPV_r_I47V | FPV/r | PI | 3 | I47V | Major | No | 35 | 35.0 | 145 | 24.1% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| FPV_r_K20T | FPV/r | PI | 3 | K20T | Accessory | No | 5 | 5.0 | 145 | 3.4% | Minor | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| FPV_r_L33F | FPV/r | PI | 3 | L33F | Accessory | No | 10 | 10.0 | 145 | 6.9% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| FPV_r_L89V | FPV/r | PI | 3 | L89V | Accessory | No | 10 | 10.0 | 145 | 6.9% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| FPV_r_L90M | FPV/r | PI | 3 | L90M | Major | No | 20 | 20.0 | 145 | 13.8% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| FPV_r_V11L_+_V32I | FPV/r | PI | 3 | V11L + V32I | Major | No | 5 | 5.0 | 145 | 3.4% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| FPV_r_V32I | FPV/r | PI | 3 | V32I | Major | No | 30 | 30.0 | 145 | 20.7% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| FPV_r_V32I_+_I47V | FPV/r | PI | 3 | V32I + I47V | Major | No | 5 | 5.0 | 145 | 3.4% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| FPV_r_V32I_+_L89V | FPV/r | PI | 3 | V32I + L89V | Major | No | 5 | 5.0 | 145 | 3.4% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| IDV_r_G73S | IDV/r | PI | 3 | G73S | Accessory | No | 15 | 15.0 | 115 | 13.0% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| IDV_r_G73S_+_L90M | IDV/r | PI | 3 | G73S + L90M | Major | No | 10 | 10.0 | 115 | 8.7% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| IDV_r_I47V | IDV/r | PI | 3 | I47V | Major | No | 15 | 15.0 | 115 | 13.0% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| IDV_r_K20T | IDV/r | PI | 3 | K20T | Accessory | No | 5 | 5.0 | 115 | 4.3% | Minor | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| IDV_r_L33F | IDV/r | PI | 3 | L33F | Accessory | No | 5 | 5.0 | 115 | 4.3% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| IDV_r_L89V | IDV/r | PI | 3 | L89V | Accessory | No | 5 | 5.0 | 115 | 4.3% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| IDV_r_L90M | IDV/r | PI | 3 | L90M | Major | No | 30 | 30.0 | 115 | 26.1% | Significant | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| IDV_r_V11L_+_V32I | IDV/r | PI | 3 | V11L + V32I | Major | No | 5 | 5.0 | 115 | 4.3% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| IDV_r_V32I | IDV/r | PI | 3 | V32I | Major | No | 15 | 15.0 | 115 | 13.0% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| IDV_r_V32I_+_I47V | IDV/r | PI | 3 | V32I + I47V | Major | No | 5 | 5.0 | 115 | 4.3% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| IDV_r_V32I_+_L89V | IDV/r | PI | 3 | V32I + L89V | Major | No | 5 | 5.0 | 115 | 4.3% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| LPV_r_G73S | LPV/r | PI | 3 | G73S | Accessory | No | 5 | 5.0 | 65 | 7.7% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| LPV_r_I47V | LPV/r | PI | 3 | I47V | Major | No | 15 | 15.0 | 65 | 23.1% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| LPV_r_L33F | LPV/r | PI | 3 | L33F | Accessory | No | 5 | 5.0 | 65 | 7.7% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| LPV_r_L90M | LPV/r | PI | 3 | L90M | Major | No | 10 | 10.0 | 65 | 15.4% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| LPV_r_V11L_+_V32I | LPV/r | PI | 3 | V11L + V32I | Major | No | 5 | 5.0 | 65 | 7.7% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| LPV_r_V32I | LPV/r | PI | 3 | V32I | Major | No | 15 | 15.0 | 65 | 23.1% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| LPV_r_V32I_+_I47V | LPV/r | PI | 3 | V32I + I47V | Major | No | 5 | 5.0 | 65 | 7.7% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| LPV_r_V32I_+_L89V | LPV/r | PI | 3 | V32I + L89V | Major | No | 5 | 5.0 | 65 | 7.7% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| NFV_G73S | NFV | PI | 3 | G73S | Accessory | No | 15 | 15.0 | 180 | 8.3% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| NFV_G73S_+_L90M | NFV | PI | 3 | G73S + L90M | Major | No | 10 | 10.0 | 180 | 5.6% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| NFV_I47V | NFV | PI | 3 | I47V | Major | No | 20 | 20.0 | 180 | 11.1% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| NFV_K20T | NFV | PI | 3 | K20T | Accessory | No | 15 | 15.0 | 180 | 8.3% | Minor | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| NFV_L33F | NFV | PI | 3 | L33F | Accessory | No | 10 | 10.0 | 180 | 5.6% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| NFV_L89V | NFV | PI | 3 | L89V | Accessory | No | 10 | 10.0 | 180 | 5.6% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| NFV_L90M | NFV | PI | 3 | L90M | Major | No | 60 | 60.0 | 180 | 33.3% | Significant | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| NFV_Q58E | NFV | PI | 3 | Q58E | Accessory | No | 10 | 10.0 | 180 | 5.6% | Minor | Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance. |
| NFV_V11L_+_V32I | NFV | PI | 3 | V11L + V32I | Major | No | 5 | 5.0 | 180 | 2.8% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| NFV_V32I | NFV | PI | 3 | V32I | Major | No | 15 | 15.0 | 180 | 8.3% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| NFV_V32I_+_I47V | NFV | PI | 3 | V32I + I47V | Major | No | 5 | 5.0 | 180 | 2.8% | Minor | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| NFV_V32I_+_L89V | NFV | PI | 3 | V32I + L89V | Major | No | 5 | 5.0 | 180 | 2.8% | Minor | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| SQV_r_G73S | SQV/r | PI | 3 | G73S | Accessory | No | 15 | 15.0 | 80 | 18.8% | Minor | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| SQV_r_G73S_+_L90M | SQV/r | PI | 3 | G73S + L90M | Major | No | 10 | 10.0 | 80 | 12.5% | Minor | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| SQV_r_K20T | SQV/r | PI | 3 | K20T | Accessory | No | 5 | 5.0 | 80 | 6.2% | Minor | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| SQV_r_L33F | SQV/r | PI | 3 | L33F | Accessory | No | 5 | 5.0 | 80 | 6.2% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| SQV_r_L90M | SQV/r | PI | 3 | L90M | Major | No | 45 | 45.0 | 80 | 56.2% | Major | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| TPV_r_I47V | TPV/r | PI | 3 | I47V | Major | No | 30 | 30.0 | 60 | 50.0% | Major | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| TPV_r_L33F | TPV/r | PI | 3 | L33F | Accessory | No | 10 | 10.0 | 60 | 16.7% | Minor | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| TPV_r_Q58E | TPV/r | PI | 3 | Q58E | Accessory | No | 15 | 15.0 | 60 | 25.0% | Significant | Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance. |
| TPV_r_V32I | TPV/r | PI | 3 | V32I | Major | No | 5 | 5.0 | 60 | 8.3% | Minor | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
PR Mutations
Comprehensive listing of all mutations detected in the PR gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.
Filterable table of detected protease mutations with positions, attributes, and special labels (SDRM, APOBEC, unusual variants).
| Mutation | Mutation | Position | Type | SDRM | APOBEC | Unusual | Structure |
|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_A71V | A71V | 71 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_C95V | C95V | 95 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_D60E | D60E | 60 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_E35G | E35G | 35 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_G73S | G73S | 73 | Accessory | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_I13V | I13V | 13 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I15V | I15V | 15 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I47V | I47V | 47 | Major | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_I62V | I62V | 62 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I93L | I93L | 93 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_K20T | K20T | 20 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_K70E | K70E | 70 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L10R | L10R | 10 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L19I | L19I | 19 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L33F | L33F | 33 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_L63P | L63P | 63 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L89V | L89V | 89 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_L90M | L90M | 90 | Major | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_M36I | M36I | 36 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_N37T | N37T | 37 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_P39PS | P39PS | 39 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_Q58E | Q58E | 58 | Accessory | No | No | No | Substitution |
| DEMO_COMBO_NGS_R41K | R41K | 41 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V11L | V11L | 11 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V32I | V32I | 32 | Major | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_V77I | V77I | 77 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V82I | V82I | 82 | Other | No | No | No | Substitution |
PR Mutation Summary
Summary of mutation types detected in the PR gene, including counts, percentages, and complete lists of mutations by type.
Distribution of protease mutation types with counts, percentages, and representative examples, including SDRM and APOBEC-associated categories.
| Mutation Type | Count | Percentage | Mutations | Clinical Implication |
|---|---|---|---|---|
| Major | 3 | 11.1% | I47V, L90M, V32I | Direct resistance to one or more drugs |
| Accessory | 5 | 18.5% | G73S, K20T, L33F, L89V, Q58E | Enhance resistance when present with major mutations |
| SDRM | 4 | 14.8% | G73S, I47V, L90M, V32I | Used for surveillance of transmitted resistance |
| Other | 19 | 70.4% | A71V, C95V, D60E, E35G, I13V, I15V, I62V, I93L, K70E, L10R, L19I, L63P, M36I, N37T, P39PS, R41K, V11L, V77I, V82I | Polymorphisms or mutations with minimal impact on drug resistance |
PR Mutation Clinical Significance
Consolidated analysis of PR mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.
Clinical interpretation of protease mutations grouped by importance (Major, Accessory, Other), with evidence-based notes from the Stanford HIV Drug Resistance Database.
| Mutation Type | Type | Mutation | SDRM | APOBEC | Affected Drugs | Max Impact | Clinical Implication |
|---|---|---|---|---|---|---|---|
| Accessory_G73S | Accessory | G73S | Yes | No | IDV/r (PI) (15.0), NFV (PI) (15.0), SQV/r (PI) (15.0), ATV/r (PI) (10.0), ATV/r (PI) (10.0), and 6 more | 15 | G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs. |
| Accessory_K20T | Accessory | K20T | No | No | NFV (PI) (15.0), ATV/r (PI) (5.0), FPV/r (PI) (5.0), IDV/r (PI) (5.0), SQV/r (PI) (5.0) | 15 | K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV. |
| Accessory_L33F | Accessory | L33F | No | No | FPV/r (PI) (10.0), NFV (PI) (10.0), TPV/r (PI) (10.0), ATV/r (PI) (5.0), DRV/r (PI) (5.0), and 3 more | 10 | L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV. |
| Accessory_L89V | Accessory | L89V | No | No | FPV/r (PI) (10.0), NFV (PI) (10.0), DRV/r (PI) (5.0), DRV/r (PI) (5.0), FPV/r (PI) (5.0), and 4 more | 10 | L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses. |
| Accessory_Q58E | Accessory | Q58E | No | No | TPV/r (PI) (15.0), NFV (PI) (10.0) | 15 | Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance. |
| Major_I47V | Major | I47V | Yes | No | FPV/r (PI) (35.0), TPV/r (PI) (30.0), NFV (PI) (20.0), IDV/r (PI) (15.0), LPV/r (PI) (15.0), and 8 more | 35 | I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV. |
| Major_L90M | Major | L90M | Yes | No | NFV (PI) (60.0), SQV/r (PI) (45.0), IDV/r (PI) (30.0), ATV/r (PI) (20.0), FPV/r (PI) (20.0), and 6 more | 60 | L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV. |
| Major_V32I | Major | V32I | Yes | No | FPV/r (PI) (30.0), ATV/r (PI) (15.0), DRV/r (PI) (15.0), IDV/r (PI) (15.0), LPV/r (PI) (15.0), and 18 more | 30 | V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs. |
| Other_V11L | Other | V11L | No | No | DRV/r (PI) (5.0), FPV/r (PI) (5.0), IDV/r (PI) (5.0), LPV/r (PI) (5.0), NFV (PI) (5.0) | 5 | V11I/L are relatively non-polymorphic accessory mutation selected in persons receiving DRV. V11L is a nonpolymorphic PI-selected mutation associated with reduced in vitro DRV susceptibility when it occurs in combination with other PI-resistance mutations. |
PR Drug Resistance Profile
Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for PR gene.
Drug-level protease inhibitor resistance with quantitative scores, weighted clinical impact, and interpretation to support PI regimen selection.
| Drug | Drug | Class | Score | Weighted Score | Priority | SIR | Level | Interpretation |
|---|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_ATV_r | ATV/r | PI | 80 | 80.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_DRV_r | DRV/r | PI | 50 | 83.3 | 5 | I | 4 | Intermediate Resistance |
| DEMO_COMBO_NGS_FPV_r | FPV/r | PI | 145 | 145.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_IDV_r | IDV/r | PI | 115 | 115.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_LPV_r | LPV/r | PI | 65 | 65.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_NFV | NFV | PI | 180 | 180.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_SQV_r | SQV/r | PI | 80 | 80.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_TPV_r | TPV/r | PI | 60 | 60.0 | 3 | R | 5 | High-Level Resistance |
PR Drug Class Overview
Summary of drug resistance patterns by drug class for PR. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 1 high-priority drugs affected.
Summary of protease inhibitor (PI) class resistance, including the proportion of affected drugs and resistance-level distribution across the class.
| Drug Class | Drug Class | Total Drugs | Resistant | % Resistant | Weighted Score | High-Priority | Max Score | Status | High | Int | Low | Pot | Sus |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PR_PI | PI | 8 | 8 | 100.0% | 101.0 | 1 | 180 | High-level resistance | 7 | 1 | 0 | 0 | 0 |
RT Mutation Position Map
Interactive visualization of mutations along the RT gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.
Interactive map of RT mutation positions to highlight recurrent sites and clinically relevant regions.
RT Mutation Position Map
This visualization shows 32 mutations detected in the RT gene (positions 1-258), including 0 major resistance mutations and 8 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.
1-100
6Position 6
- E6K - OtherChanged from E to K
7Position 7
- T7P - OtherChanged from T to P
10
20
30
35Position 35
- V35T - OtherChanged from V to T
39Position 39
- T39A - OtherChanged from T to A
40
41Position 41
- M41L - NRTI (SDRM)Changed from M to L
50
60Position 60
- V60I - OtherChanged from V to I
67Position 67
- D67N - NRTI (SDRM)Changed from D to N
69Position 69
- T69D - NRTI (SDRM)Changed from T to D
70
74Position 74
- L74I - NRTI (SDRM)Changed from L to I
80
90
94Position 94
- I94L - OtherChanged from I to L
100
101-200
102Position 102
- K102L - OtherChanged from K to L
103Position 103
- K103R - OtherChanged from K to R
110
120
122Position 122
- K122E - OtherChanged from K to E
123Position 123
- D123ND - OtherChanged from D to DN
130
135Position 135
- I135T - OtherChanged from I to T
138Position 138
- E138Q - NNRTIChanged from E to Q
140
142Position 142
- I142V - OtherChanged from I to V
150
160
162Position 162
- S162D - OtherChanged from S to D
170
177Position 177
- D177N - OtherChanged from D to N
179Position 179
- V179D - NNRTIChanged from V to D
180
181Position 181
- Y181I - NNRTI (SDRM)Changed from Y to I
184Position 184
- M184V - NRTI (SDRM)Changed from M to V
190Position 190
- G190A - NNRTI (SDRM)Changed from G to A
197Position 197
- Q197E - OtherChanged from Q to E
200Position 200
- T200A - OtherChanged from T to A
201-258
202Position 202
- I202V - OtherChanged from I to V
204Position 204
- E204Q - OtherChanged from E to Q
207Position 207
- Q207KE - OtherChanged from Q to EK
210
211Position 211
- R211A - OtherChanged from R to A
215Position 215
- T215F - NRTI (SDRM)Changed from T to F
219Position 219
- K219H - OtherChanged from K to H
220
230
240
245Position 245
- V245K - OtherChanged from V to K
250
Major Mutation (Directly confers resistance)
Accessory Mutation (Enhances resistance)
Other Mutation (Polymorphism or unknown effect)
Surveillance Drug Resistance Mutation (SDRM)
APOBEC-mediated mutation
Mutation Distribution Summary
| Mutation Type | Count | Percentage |
|---|---|---|
| Major Mutations | 0 | 0.0% |
| Accessory Mutations | 0 | 0.0% |
| Other Mutations | 32 | 100.0% |
| SDRM Mutations | 8 | 25.0% |
| Total Mutations | 32 | 100.0% |
RT Mutation-Specific Resistance Contribution
Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in RT, highlighting the relative impact of specific mutations on drug efficacy.
Per-mutation contribution of RT variants to resistance scores for individual NRTI and NNRTI agents.
| Drug | Drug | Class | Drug Priority | Mutations | Type | SDRM | Contribution | Weighted | Total Score | % of Total | Impact Category | Clinical Comment |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3TC_M184V | 3TC | NRTI | 4 | M184V | Other | No | 60 | 80.0 | 60 | 100.0% | Dominant | M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance. |
| ABC_D67N | ABC | NRTI | 3 | D67N | Other | No | 5 | 5.0 | 75 | 6.7% | Minor | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| ABC_L74I | ABC | NRTI | 3 | L74I | Other | No | 15 | 15.0 | 75 | 20.0% | Minor | L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility. |
| ABC_M41L | ABC | NRTI | 3 | M41L | Other | No | 5 | 5.0 | 75 | 6.7% | Minor | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| ABC_M41L_+_D67N_+_T215F | ABC | NRTI | 3 | M41L + D67N + T215F | Other | No | 5 | 5.0 | 75 | 6.7% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| ABC_M41L_+_M184V_+_T215F | ABC | NRTI | 3 | M41L + M184V + T215F | Other | No | 10 | 10.0 | 75 | 13.3% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| ABC_M41L_+_T215F | ABC | NRTI | 3 | M41L + T215F | Other | No | 10 | 10.0 | 75 | 13.3% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| ABC_M184V | ABC | NRTI | 3 | M184V | Other | No | 15 | 15.0 | 75 | 20.0% | Minor | M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance. |
| ABC_T215F | ABC | NRTI | 3 | T215F | Other | No | 10 | 10.0 | 75 | 13.3% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| AZT_D67N | AZT | NRTI | 3 | D67N | Other | No | 15 | 15.0 | 95 | 15.8% | Minor | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| AZT_M41L | AZT | NRTI | 3 | M41L | Other | No | 15 | 15.0 | 95 | 15.8% | Minor | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| AZT_M41L_+_D67N_+_T215F | AZT | NRTI | 3 | M41L + D67N + T215F | Other | No | 5 | 5.0 | 95 | 5.3% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| AZT_M41L_+_T215F | AZT | NRTI | 3 | M41L + T215F | Other | No | 10 | 10.0 | 95 | 10.5% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| AZT_T215F | AZT | NRTI | 3 | T215F | Other | No | 60 | 60.0 | 95 | 63.2% | Major | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| D4T_D67N | D4T | NRTI | 3 | D67N | Other | No | 15 | 15.0 | 85 | 17.6% | Minor | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| D4T_M41L | D4T | NRTI | 3 | M41L | Other | No | 15 | 15.0 | 85 | 17.6% | Minor | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| D4T_M41L_+_D67N_+_T215F | D4T | NRTI | 3 | M41L + D67N + T215F | Other | No | 5 | 5.0 | 85 | 5.9% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| D4T_M41L_+_T215F | D4T | NRTI | 3 | M41L + T215F | Other | No | 10 | 10.0 | 85 | 11.8% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| D4T_T69D | D4T | NRTI | 3 | T69D | Other | No | 10 | 10.0 | 85 | 11.8% | Minor | T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility. |
| D4T_T215F | D4T | NRTI | 3 | T215F | Other | No | 40 | 40.0 | 85 | 47.1% | Significant | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| DDI_D67N | DDI | NRTI | 3 | D67N | Other | No | 5 | 5.0 | 145 | 3.4% | Minor | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| DDI_L74I | DDI | NRTI | 3 | L74I | Other | No | 60 | 60.0 | 145 | 41.4% | Significant | L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility. |
| DDI_M41L | DDI | NRTI | 3 | M41L | Other | No | 10 | 10.0 | 145 | 6.9% | Minor | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| DDI_M41L_+_D67N_+_T215F | DDI | NRTI | 3 | M41L + D67N + T215F | Other | No | 5 | 5.0 | 145 | 3.4% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| DDI_M41L_+_T215F | DDI | NRTI | 3 | M41L + T215F | Other | No | 10 | 10.0 | 145 | 6.9% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| DDI_M184V | DDI | NRTI | 3 | M184V | Other | No | 10 | 10.0 | 145 | 6.9% | Minor | M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance. |
| DDI_T69D | DDI | NRTI | 3 | T69D | Other | No | 30 | 30.0 | 145 | 20.7% | Minor | T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility. |
| DDI_T215F | DDI | NRTI | 3 | T215F | Other | No | 15 | 15.0 | 145 | 10.3% | Minor | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| DOR_Y181I | DOR | NNRTI | 3 | Y181I | Other | No | 10 | 10.0 | 20 | 50.0% | Major | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| DOR_Y181I_+_G190A | DOR | NNRTI | 3 | Y181I + G190A | Other | No | 10 | 10.0 | 20 | 50.0% | Major | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| DPV_E138Q | DPV | NNRTI | 3 | E138Q | Other | No | 20 | 20.0 | 105 | 19.0% | Minor | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| DPV_G190A | DPV | NNRTI | 3 | G190A | Other | No | 15 | 15.0 | 105 | 14.3% | Minor | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| DPV_V179D | DPV | NNRTI | 3 | V179D | Other | No | 10 | 10.0 | 105 | 9.5% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| DPV_Y181I | DPV | NNRTI | 3 | Y181I | Other | No | 60 | 60.0 | 105 | 57.1% | Major | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| EFV_E138Q | EFV | NNRTI | 3 | E138Q | Other | No | 10 | 10.0 | 115 | 8.7% | Minor | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| EFV_G190A | EFV | NNRTI | 3 | G190A | Other | No | 45 | 45.0 | 115 | 39.1% | Significant | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| EFV_K103R_+_V179D | EFV | NNRTI | 3 | K103R + V179D | Other | No | 20 | 20.0 | 115 | 17.4% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| EFV_V179D | EFV | NNRTI | 3 | V179D | Other | No | 10 | 10.0 | 115 | 8.7% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| EFV_Y181I | EFV | NNRTI | 3 | Y181I | Other | No | 30 | 30.0 | 115 | 26.1% | Significant | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| ETR_E138Q | ETR | NNRTI | 3 | E138Q | Other | No | 10 | 10.0 | 100 | 10.0% | Minor | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| ETR_G190A | ETR | NNRTI | 3 | G190A | Other | No | 10 | 10.0 | 100 | 10.0% | Minor | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| ETR_V179D | ETR | NNRTI | 3 | V179D | Other | No | 10 | 10.0 | 100 | 10.0% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| ETR_Y181I | ETR | NNRTI | 3 | Y181I | Other | No | 60 | 60.0 | 100 | 60.0% | Major | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| ETR_Y181I_+_G190A | ETR | NNRTI | 3 | Y181I + G190A | Other | No | 10 | 10.0 | 100 | 10.0% | Minor | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| FTC_M184V | FTC | NRTI | 4 | M184V | Other | No | 60 | 80.0 | 60 | 100.0% | Dominant | M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance. |
| NVP_E138Q | NVP | NNRTI | 3 | E138Q | Other | No | 10 | 10.0 | 160 | 6.2% | Minor | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| NVP_G190A | NVP | NNRTI | 3 | G190A | Other | No | 60 | 60.0 | 160 | 37.5% | Significant | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| NVP_K103R_+_V179D | NVP | NNRTI | 3 | K103R + V179D | Other | No | 20 | 20.0 | 160 | 12.5% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| NVP_V179D | NVP | NNRTI | 3 | V179D | Other | No | 10 | 10.0 | 160 | 6.2% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| NVP_Y181I | NVP | NNRTI | 3 | Y181I | Other | No | 60 | 60.0 | 160 | 37.5% | Significant | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| RPV_E138Q | RPV | NNRTI | 3 | E138Q | Other | No | 20 | 20.0 | 130 | 15.4% | Minor | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| RPV_G190A | RPV | NNRTI | 3 | G190A | Other | No | 15 | 15.0 | 130 | 11.5% | Minor | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| RPV_K103R_+_V179D | RPV | NNRTI | 3 | K103R + V179D | Other | No | 15 | 15.0 | 130 | 11.5% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| RPV_V179D | RPV | NNRTI | 3 | V179D | Other | No | 10 | 10.0 | 130 | 7.7% | Minor | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| RPV_Y181I | RPV | NNRTI | 3 | Y181I | Other | No | 60 | 60.0 | 130 | 46.2% | Significant | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| RPV_Y181I_+_G190A | RPV | NNRTI | 3 | Y181I + G190A | Other | No | 10 | 10.0 | 130 | 7.7% | Minor | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| TDF_D67N | TDF | NRTI | 4 | D67N | Other | No | 5 | 6.7 | 30 | 16.7% | Minor (High-Priority Drug) | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| TDF_L74I | TDF | NRTI | 4 | L74I | Other | No | 5 | 6.7 | 30 | 16.7% | Minor (High-Priority Drug) | L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility. |
| TDF_M41L | TDF | NRTI | 4 | M41L | Other | No | 5 | 6.7 | 30 | 16.7% | Minor (High-Priority Drug) | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| TDF_M41L_+_D67N_+_T215F | TDF | NRTI | 4 | M41L + D67N + T215F | Other | No | 5 | 6.7 | 30 | 16.7% | Minor (High-Priority Drug) | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| TDF_M41L_+_T215F | TDF | NRTI | 4 | M41L + T215F | Other | No | 10 | 13.3 | 30 | 33.3% | Significant (High-Priority Drug) | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| TDF_T215F | TDF | NRTI | 4 | T215F | Other | No | 10 | 13.3 | 30 | 33.3% | Significant (High-Priority Drug) | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
RT Mutations
Comprehensive listing of all mutations detected in the RT gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.
Searchable inventory of reverse transcriptase mutations with genomic position, mutation properties, and special classifications.
| Mutation | Mutation | Position | Type | SDRM | APOBEC | Unusual | Structure |
|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_D67N | D67N | 67 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_D123ND | D123ND | 123 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_D177N | D177N | 177 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_E6K | E6K | 6 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_E138Q | E138Q | 138 | NNRTI | No | No | No | Substitution |
| DEMO_COMBO_NGS_E204Q | E204Q | 204 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_G190A | G190A | 190 | NNRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_I94L | I94L | 94 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I135T | I135T | 135 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I142V | I142V | 142 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_I202V | I202V | 202 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_K102L | K102L | 102 | Other | No | No | Yes | Substitution |
| DEMO_COMBO_NGS_K103R | K103R | 103 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_K122E | K122E | 122 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_K219H | K219H | 219 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_L74I | L74I | 74 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_M41L | M41L | 41 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_M184V | M184V | 184 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_Q197E | Q197E | 197 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_Q207KE | Q207KE | 207 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_R211A | R211A | 211 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_S162D | S162D | 162 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_T7P | T7P | 7 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_T39A | T39A | 39 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_T69D | T69D | 69 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_T200A | T200A | 200 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_T215F | T215F | 215 | NRTI | Yes | No | No | Substitution |
| DEMO_COMBO_NGS_V35T | V35T | 35 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V60I | V60I | 60 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_V179D | V179D | 179 | NNRTI | No | No | No | Substitution |
| DEMO_COMBO_NGS_V245K | V245K | 245 | Other | No | No | No | Substitution |
| DEMO_COMBO_NGS_Y181I | Y181I | 181 | NNRTI | Yes | No | No | Substitution |
RT Mutation Summary
Summary of mutation types detected in the RT gene, including counts, percentages, and complete lists of mutations by type.
Distribution of RT mutation types (Major, Accessory, polymorphic), including TAMs, NNRTI-associated, and APOBEC-associated patterns.
| Mutation Type | Count | Percentage | Mutations | Clinical Implication |
|---|---|---|---|---|
| SDRM | 8 | 25.0% | D67N, G190A, L74I, M184V, M41L, T215F, T69D, Y181I | Used for surveillance of transmitted resistance |
| Unusual | 1 | 3.1% | K102L | Rarely observed in untreated patients |
| Other | 32 | 100.0% | D123ND, D177N, D67N, E138Q, E204Q, E6K, G190A, I135T, I142V, I202V, I94L, K102L, K103R, K122E, K219H, L74I, M184V, M41L, Q197E, Q207KE, R211A, S162D, T200A, T215F, T39A, T69D, T7P, V179D, V245K, V35T, V60I, Y181I | Polymorphisms or mutations with minimal impact on drug resistance |
RT Mutation Clinical Significance
Consolidated analysis of RT mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.
Clinical interpretation of RT mutations, including effects on drug activity and viral fitness, with linked drug-specific context.
| Mutation Type | Type | Mutation | SDRM | APOBEC | Affected Drugs | Max Impact | Clinical Implication |
|---|---|---|---|---|---|---|---|
| NNRTI_E138Q | NNRTI | E138Q | No | No | RPV (NNRTI) (20.0), DPV (NNRTI) (20.0), EFV (NNRTI) (10.0), ETR (NNRTI) (10.0), NVP (NNRTI) (10.0) | 20 | E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR. |
| NNRTI_G190A | NNRTI | G190A | Yes | No | NVP (NNRTI) (60.0), EFV (NNRTI) (45.0), RPV (NNRTI) (15.0), DPV (NNRTI) (15.0), DOR (NNRTI) (10.0), and 3 more | 60 | G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR. |
| NNRTI_V179D | NNRTI | V179D | No | No | EFV (NNRTI) (20.0), NVP (NNRTI) (20.0), RPV (NNRTI) (15.0), EFV (NNRTI) (10.0), ETR (NNRTI) (10.0), and 3 more | 20 | V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility. |
| NNRTI_Y181I | NNRTI | Y181I | Yes | No | ETR (NNRTI) (60.0), NVP (NNRTI) (60.0), RPV (NNRTI) (60.0), DPV (NNRTI) (60.0), EFV (NNRTI) (30.0), and 4 more | 60 | Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized. |
| NRTI_D67N | NRTI | D67N | Yes | No | AZT (NRTI) (15.0), D4T (NRTI) (15.0), ABC (NRTI) (5.0), ABC (NRTI) (5.0), AZT (NRTI) (5.0), and 5 more | 15 | D67N is a non-polymorphic TAM associated with low-level resistance to AZT. |
| NRTI_L74I | NRTI | L74I | Yes | No | DDI (NRTI) (60.0), ABC (NRTI) (15.0), TDF (NRTI) (5.0) | 60 | L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility. |
| NRTI_M41L | NRTI | M41L | Yes | No | AZT (NRTI) (15.0), D4T (NRTI) (15.0), ABC (NRTI) (10.0), ABC (NRTI) (10.0), AZT (NRTI) (10.0), and 11 more | 15 | M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility. |
| NRTI_M184V | NRTI | M184V | Yes | No | FTC (NRTI) (60.0), 3TC (NRTI) (60.0), ABC (NRTI) (15.0), ABC (NRTI) (10.0), DDI (NRTI) (10.0), and 3 more | 60 | M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance. |
| NRTI_T69D | NRTI | T69D | Yes | No | DDI (NRTI) (30.0), D4T (NRTI) (10.0) | 30 | T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility. |
| NRTI_T215F | NRTI | T215F | Yes | No | AZT (NRTI) (60.0), D4T (NRTI) (40.0), DDI (NRTI) (15.0), ABC (NRTI) (10.0), ABC (NRTI) (10.0), and 11 more | 60 | T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known. |
| Other_K103R | Other | K103R | No | No | EFV (NNRTI) (20.0), NVP (NNRTI) (20.0), RPV (NNRTI) (15.0) | 20 | K103R is a polymorphic mutation that alone has no effect on NNRTI susceptibility. However, in combination with V179D, it reduces NVP and EFV susceptibility about 15-fold. |
RT Drug Resistance Profile
Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for RT gene.
Drug-level RT susceptibility profile with standard and weighted scores for NRTIs and NNRTIs, aligned to clinical importance.
| Drug | Drug | Class | Score | Weighted Score | Priority | SIR | Level | Interpretation |
|---|---|---|---|---|---|---|---|---|
| DEMO_COMBO_NGS_3TC | 3TC | NRTI | 60 | 80.0 | 4 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_ABC | ABC | NRTI | 75 | 75.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_AZT | AZT | NRTI | 95 | 95.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_D4T | D4T | NRTI | 85 | 85.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_DDI | DDI | NRTI | 145 | 145.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_DOR | DOR | NNRTI | 20 | 20.0 | 3 | I | 3 | Low-Level Resistance |
| DEMO_COMBO_NGS_DPV | DPV | NNRTI | 105 | 105.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_EFV | EFV | NNRTI | 115 | 115.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_ETR | ETR | NNRTI | 100 | 100.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_FTC | FTC | NRTI | 60 | 80.0 | 4 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_NVP | NVP | NNRTI | 160 | 160.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_RPV | RPV | NNRTI | 130 | 130.0 | 3 | R | 5 | High-Level Resistance |
| DEMO_COMBO_NGS_TDF | TDF | NRTI | 30 | 40.0 | 4 | I | 4 | Intermediate Resistance |
RT Drug Class Overview
Summary of drug resistance patterns by drug class for RT. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 3 high-priority drugs affected.
Summary of RT inhibitor resistance across NRTI and NNRTI classes, with class-level metrics and priority drug indicators.
| Drug Class | Drug Class | Total Drugs | Resistant | % Resistant | Weighted Score | High-Priority | Max Score | Status | High | Int | Low | Pot | Sus |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RT_NNRTI | NNRTI | 6 | 6 | 100.0% | 105.0 | 0 | 160 | High-level resistance | 5 | 0 | 1 | 0 | 0 |
| RT_NRTI | NRTI | 7 | 7 | 100.0% | 85.7 | 3 | 145 | High-level resistance | 6 | 1 | 0 | 0 | 0 |